tetrabenazine

Drug-drug:

Concurrent use of MAO inhibitors↑ risk of serious adverse reactions and is contraindicated; wait at least 14 days after discontinuing to initiate tetrabenazine.
Reserpine binds to VMAT-2 and depletes monoamines in the CNS; concurrent use contraindicated; wait 3 wk after discontinuing to initiate tetrabenazine.
Concurrent use of deutetrabenazine or valbenazine is contraindicated.
Blood levels are ↑ by drugs that inhibit the CYP2D6 enzyme system including fluoxetine, paroxetine, and quinidine; initial dose ↓ of tetrabenazine recommended.
Concurrent use with neuroleptic drugs or dopamine antagonists including haloperidol, chlorpromazine, risperidone, and olanzapine may ↑ risk of QTc interval prolongation, neuroleptic malignant syndrome and extrapyramidal disorders.
Concurrent use of alcohol or other CNS depressants may ↑ risk of CNS depression.

Availability ⬆ ⬇

(Generic available)

Tablets: 12.5 mg; 25 mg

Route/Dosage ⬆ ⬇

PO (Adults ): 12.5 mg/day for one wk initially, ↑ by 12.5 weekly up to 37.5–50 mg/day in 3 divided doses; Concurrent use of strong CYP2D6 inhibitors or poor CYP2D6 metabolizers—start with initial dose of 6.25 mg, titrate carefully.

US Brand Names ⬆ ⬇

Action ⬆ ⬇

Acts as a reversible inhibitor of the vesicle monoamine transporter type 2 (VMAT-2); which inhibits the reuptake of serotonin, norepinephrine and dopamine into vesicles in presynaptic neurons.

Therapeutic effects:

Decreased chorea due to Huntington's Disease.

Classifications ⬆ ⬇

Therapeutic Classification: antichoreas

Pharmacologic Classification: reversible monoamine depleters

Pharmacokinetics ⬆ ⬇

Absorption: ≥75% absorbed following oral administration.

Distribution: Crosses the blood-brain barrier.

Metabolism/Excretion: Rapidly and extensively metabolized by the liver; CYP2D6 plays a large role in the metabolic process (the CYP2D6 enzyme system exhibits genetic polymorphism; 7% of population may be poor metabolizers and may have significantly ↑ concentrations and an ↑ risk of adverse effects). Metabolites are renally excreted. Two metabolites α-dihydrotetrabenazine (α-HTBZ) and β-HTBZ bind to VMAT-2 and are pharmacologically active.

Half-Life: α-HTBZ—4–8 hrs; β-HTBZ—2–4 hr.

Canadian Brand Names ⬆ ⬇

Time/Action Profile ⬆ ⬇

(blood levels)

ROUTE	ONSET	PEAK	DURATION
PO	unknown	1.0–1.5 hr	12–18 hr*

*Return of symptoms following discontinuation.

Patient/Family Teaching ⬆ ⬇

Instruct patient to take tetrabenazine as directed. Do not take more or stop taking tetrabenazine without consulting health care professional. Dose adjustment may take several wk. Discuss procedure for missed doses with health care professional before beginning therapy; do not double doses. If a dose is missed or medication discontinued, involuntary movements will return or worsen in 12–18 hr. If tetrabenazine is stopped for more than 5 days, consult health care professional before taking another dose; lower dose may be required. Advise patient to read Medication Guide before starting and with each Rx refill in case of changes.
Advise patient and family to monitor for changes, especially sudden changes, in mood, behaviors, thoughts or feelings. If new or worse feelings of sadness or crying spells, lack of interest in friends or activities, sleeping a lot more or less, feelings of unimportance, guilt, hopelessness or helplessness, irritability or aggression, more or less hungry, difficulty paying attention, or thoughts of hurting self or ending life occur, notify health care professional promptly.
Causes sedation. Caution patient to avoid driving and other activities requiring alertness until response to medication is known.
Advise patient to avoid alcohol and other CNS depressants during therapy; ↑ sedation.
Inform patient of potential side effects and instruct to notify health care professional if side effects occur.
Instruct patient to notify health care professional of all Rx or OTC medications, vitamins, or herbal products being taken and consult health care professional before taking any new medications.
Advise female patients to notify health care professional if pregnancy is planned or suspected or if breastfeeding.

Pronunciation ⬆ ⬇

Code ⬆

NDC Code

0054- Hikma Pharmaceuticals USA Inc.
- 0054-0468- Tetrabenazine
  - 0054-0468-23- 112 TABLET in 1 BOTTLE (0054-0468-23)

0054- Hikma Pharmaceuticals USA Inc.
- 0054-0469- Tetrabenazine
  - 0054-0469-23- 112 TABLET in 1 BOTTLE (0054-0469-23)

31722- Camber Pharmaceuticals, Inc.
- 31722-821- Tetrabenazine
  - 31722-821-11- 112 TABLET, COATED in 1 BOTTLE (31722-821-11)

31722- Camber Pharmaceuticals, Inc.
- 31722-821- Tetrabenazine
  - 31722-821-31- 10 TABLET, COATED in 1 BLISTER PACK (31722-821-31)

31722- Camber Pharmaceuticals, Inc.
- 31722-821- Tetrabenazine
  - 31722-821-32- 100 TABLET, COATED in 1 CARTON (31722-821-32)

31722- Camber Pharmaceuticals, Inc.
- 31722-821- Tetrabenazine
  - 31722-821-56- 56 TABLET, COATED in 1 BOTTLE (31722-821-56)

31722- Camber Pharmaceuticals, Inc.
- 31722-822- Tetrabenazine
  - 31722-822-11- 112 TABLET, COATED in 1 BOTTLE (31722-822-11)

31722- Camber Pharmaceuticals, Inc.
- 31722-822- Tetrabenazine
  - 31722-822-31- 10 TABLET, COATED in 1 BLISTER PACK (31722-822-31)

31722- Camber Pharmaceuticals, Inc.
- 31722-822- Tetrabenazine
  - 31722-822-32- 100 TABLET, COATED in 1 CARTON (31722-822-32)

31722- Camber Pharmaceuticals, Inc.
- 31722-822- Tetrabenazine
  - 31722-822-56- 56 TABLET, COATED in 1 BOTTLE (31722-822-56)

42291- AvKARE, Inc.
- 42291-806- Tetrabenazine
  - 42291-806-30- 30 TABLET in 1 BOTTLE (42291-806-30)

42291- AvKARE, Inc.
- 42291-807- Tetrabenazine
  - 42291-807-30- 30 TABLET in 1 BOTTLE (42291-807-30)

43598- Dr. Reddys Laboratories Inc
- 43598-394- Tetrabenazine
  - 43598-394-05- 500 TABLET in 1 BOTTLE (43598-394-05)

43598- Dr. Reddys Laboratories Inc
- 43598-394- Tetrabenazine
  - 43598-394-67- 112 TABLET in 1 BOTTLE (43598-394-67)

43598- Dr. Reddys Laboratories Inc
- 43598-395- Tetrabenazine
  - 43598-395-05- 500 TABLET in 1 BOTTLE (43598-395-05)

43598- Dr. Reddys Laboratories Inc
- 43598-395- Tetrabenazine
  - 43598-395-67- 112 TABLET in 1 BOTTLE (43598-395-67)

47335- Sun Pharmaceutical Industries, Inc.
- 47335-179- Tetrabenazine
  - 47335-179-23- 112 TABLET in 1 BOTTLE (47335-179-23)

47335- Sun Pharmaceutical Industries, Inc.
- 47335-277- Tetrabenazine
  - 47335-277-23- 112 TABLET in 1 BOTTLE (47335-277-23)

51224- TAGI Pharma, Inc.
- 51224-425- TETRABENAZINE
  - 51224-425-10- 112 TABLET in 1 BOTTLE (51224-425-10)

51224- TAGI Pharma, Inc.
- 51224-426- TETRABENAZINE
  - 51224-426-10- 112 TABLET in 1 BOTTLE (51224-426-10)

67386- Lundbeck Pharmaceuticals LLC
- 67386-421- Xenazine
  - 67386-421-01- 112 TABLET in 1 BOTTLE (67386-421-01)

67386- Lundbeck Pharmaceuticals LLC
- 67386-422- Xenazine
  - 67386-422-01- 112 TABLET in 1 BOTTLE (67386-422-01)

68180- Lupin Pharmaceuticals, Inc.
- 68180-408- Tetrabenazine
  - 68180-408-58- 112 TABLET in 1 BOTTLE (68180-408-58)

68180- Lupin Pharmaceuticals, Inc.
- 68180-409- Tetrabenazine
  - 68180-409-58- 112 TABLET in 1 BOTTLE (68180-409-58)

68682- Oceanside Pharmaceuticals
- 68682-421- tetrabenazine
  - 68682-421-12- 112 TABLET in 1 BOTTLE (68682-421-12)

68682- Oceanside Pharmaceuticals
- 68682-422- tetrabenazine
  - 68682-422-25- 112 TABLET in 1 BOTTLE (68682-422-25)

69452- Bionpharma Inc.
- 69452-117- TETRABENAZINE
  - 69452-117-21- 112 TABLET in 1 BOTTLE (69452-117-21)

69452- Bionpharma Inc.
- 69452-118- TETRABENAZINE
  - 69452-118-21- 112 TABLET in 1 BOTTLE (69452-118-21)

section name header

Indications ⬇

Contraind./Precautions ⬆ ⬇

Adv. Reactions/Side Effects ⬆ ⬇

Interactions ⬆ ⬇